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Case report
Apixaban-induced haematoma causing small bowel intussusception
  1. Ariel P Santos1,2,
  2. Jennifer M Rodriguez3 and
  3. Grace Berry1,2
  1. 1Surgery, Texas Tech University, Lubbock, TX, USA
  2. 2Department of Surgery, Covenant Medical Center—19th Street Campus, Lubbock, TX, USA
  3. 3Department of Pathology, Southlake Regional Health Centre, Newmarket, Ontario, Canada
  1. Correspondence to Dr Ariel P Santos; ariel.santos{at}ttuhsc.edu

Abstract

Apixaban (Eliquis) is a direct acting oral anticoagulant (DOAC) indicated for treatment of deep vein thrombosis, non-valvular atrial fibrillation, pulmonary embolism and postoperative venous thromboprophylaxis following hip or knee replacement. Complications are minimal and include, but are not limited to, bleeding and intracranial haemorrhage, and haematoma formation. Our patient is a 73-year-old woman who presented with clinical and radiographic findings of small bowel obstruction. She was found to be taking apixaban for atrial fibrillation. CT scan showed small bowel intussusception. She underwent an exploratory laparotomy and resection of the small bowel intussusception with primary side-to-side anastomosis. Histopathological examination showed that the intussusception was caused by an intramural haematoma. This case presents a rare instance of adult intussusception caused by a DOAC. To our knowledge, no case of intussusception caused by apixaban has yet been found in literature.

  • gastrointestinal system
  • haematology (drugs and medicines)
  • general surgery
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Footnotes

  • Twitter @traumamd1

  • Contributors GB: first drafting and writing of the manuscript, chart review and editing. APS conceptualised the idea of the paper, surgeon, obtained the consent, obtained the images, research, co-wrote the manuscript, major editing and revision, final drafting and submission. JMR: review, co-wrote the manuscript, major revision and proof reading of the manuscript and final drafting of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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